Provider Demographics
NPI:1831135045
Name:MACMASTER, JOHN C (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:MACMASTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MI
Mailing Address - Zip Code:48742-0279
Mailing Address - Country:US
Mailing Address - Phone:989-736-3020
Mailing Address - Fax:989-736-8278
Practice Address - Street 1:177 N BARLOW RD
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48740-9607
Practice Address - Country:US
Practice Address - Phone:989-736-8157
Practice Address - Fax:989-358-3762
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101009518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1990647Medicaid
Z16001008Medicare ID - Type Unspecified
F03664Medicare UPIN